Mario Noli Guda Legarde III

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

644568 Issued in TX

Practice address

7400 Merton Minter St
San Antonio, TX 78229-4404

Phone

(210) 863-7081

NPI assigned

Dec 23, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1467260414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 BONITA SPGS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584253",
            "telephone_number": "210-844-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-863-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGARDE",
        "first_name": "MARIO NOLI",
        "middle_name": "GUDA",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "TX",
            "license": "644568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Healthcare Services Inc (Legacy Rehabilitation Services, Inc.)
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• Legacy Psychological Services, PLLC
• Legacy Trails Medical Center
• Legacy Valley Counseling
• Gary Laurent Legault, M.D.
• Legend Oaks - Sonterra, LLC (Sonterra Health Center)
• Legend Oaks - South San Antonio, LLC (Legend Oaks Healthcare and Rehabilitation Center - San Antonio)
• Legend Oaks - West San Antonio (Legend Oaks Healthcare and Rehabilitation - West San Antonio)
• Legend Oaks-South San Antonio, LLC (Legend Oaks Healthcare and Rehabilitation Center-San Antonio)

• Administrator Registered Nurse in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Administrator Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.